Safe Abortion Care And Access Flashcards
What should be done when a patient presents for termination of pregnancy request?
Timely referral to abortion services
Counselling referral - may be done as part of abortion provider
History and medical assessment
- risk factors
- are they suitable for medical or surgical?
- are they vulnerable, domestic violence, underage
Information providence
- what is involved
- risks
Confirm gestation
- typically via USS
- blood group
- STD screen and treat before (if not possible antibiotic prophylaxis before procedure)
Discuss future contraception
How many doctors have to independently agree that the patient meets the abortion criteria as stated in the Abortion Act 1967?
2
Who should anti D prophylaxis be offered to?
Women who are rhesus D negative and are having an abortion after 10 weeks gestation
Women who are rhesus negative and are having a surgical abortion up to and including 10 weeks gestation
Who should antibiotic prophylaxis be offered to?
Surgical abortion
NICE suggests antibiotic prophylaxis not routinely offered for medical prophylaxis
Is having an abortion associated with increased risk of infertility, breast cancer or mental health?
No
What information should women be provided with?
The differences between medical and surgical abortion, including risks and benefits - do this without being directive
- NICE patient decision aids
Information to help prepare e.g what it involves and what happens afterwards, how much pain and bleeding to expect
Information about what to expect afterwards
Can women who are having a medical abortion see the products of pregnancy as they are passed?
Yes they may do
Do women under 16 have to tell their parents they are having an abortion?
No, if both doctors deem that patient has sufficient understanding of procedure and implications.
Encourage to involve parents, carer or supportive adult, but not necessary.
All information, advice and services are confidential. However, can tell social services if concerned about abuse - have to talk to patient about this first.
Does the partner/ person the woman got pregnant with need to be informed?
No
The person you got pregnant with has no legal rights
An appointment should be offered within….for first consultation
5 working days
- confirm pregnancy
- see if abortion is possible
- see if other procedures necessary e.g STI testing and treatment
The abortion should go ahead within how many days of the decision to go ahead?
5 days
Should a cervical screening be offered?
Yes if not had one within last 3 years
When is a follow up appointment particularly important?
After early medical abortion - check the abortion is complete.
A follow up should be offered within 2 weeks if the patient wishes
Is bleeding after abortion normal?
Yes
How long depends on the abortion method. Bleeding after medical abortion can last several weeks. Bleeding after surgical can last about 2 weeks.
Either can be spotting of heavy.
If very heavy seek advice straight away
Will having an abortion affect chances of having a baby in the future?
No if there are no problems with the abortion, such as injury to uterus or cervix - not common
